目的:确定抑郁症(MDD)患者在奖赏过程中全脑功能连接(FC)的时空模式变化,并确定连接组差异的临床相关性。
方法:61例MDD患者和32例健康对照者纳入研究。在脑磁图(MEG)扫描期间,所有参与者都完成了面部情绪识别任务.将MDD患者进一步分为两组:忧郁(n=31)和非忧郁(n=30),基于迷你国际神经精神病学访谈(M.I.N.I.)评估。使用汉密尔顿抑郁量表(HAM-D6)的6项忧郁子量表检查忧郁症状。在快乐情绪刺激(0-200ms,100-300ms,200-400ms,300-500ms,和400-600ms)。然后,基于网络的统计量(NBS)用于确定忧郁性MDD患者的特定异常连接模式.
结果:NBS确定了三组中后期(300-500ms)对快乐面孔的反应的子网络差异(校正P=0.035)。然后,事后分析和相关分析发现,在忧郁性MDD患者中,有5个FCs降低,并且与HAM-D6评分相关,包括左梭状回-右眶额下回的FCs(r=-0.52,P<0.001),左梭状回-左杏仁核(r=-0.26,P=0.049),左后扣带回-右前肌(r=-0.32,P=0.025),左前肌-右前肌(r=-0.27,P=0.049),左前肌-左枕下回(r=-0.32,P=0.025)。
结论:在回应幸福的面孔时,忧郁的MDD患者表现出功能连接模式中断(20-35Hz,300-500ms),涉及视觉信息处理和边缘系统的大脑区域。奖赏过程中的异常功能连接模式可能是忧郁性MDD的生物标志物。
OBJECTIVE: To identify the spatial-temporal pattern variation of whole-brain functional connectivity (FC) during reward processing in melancholic major depressive disorder (MDD) patients, and to determine the clinical correlates of connectomic differences.
METHODS: 61 MDD patients and 32 healthy controls were enrolled into the
study. During
magnetoencephalography (MEG) scanning, all participants completed the facial emotion recognition task. The MDD patients were further divided into two groups: melancholic (n = 31) and non-melancholic (n = 30), based on the Mini International Neuropsychiatric Interview (M.I.N.I.) assessment. Melancholic symptoms were examined by using the 6-item melancholia subscale from the Hamilton Depression Rating Scale (HAM-D6). The whole-brain orthogonalized power envelope connections in the high-beta band (20-35 Hz) were constructed in each period after the happy emotional stimuli (0-200 ms, 100-300 ms, 200-400 ms, 300-500 ms, and 400-600 ms). Then, the network-based statistic (NBS) was used to determine the specific abnormal connection patterns in melancholic MDD patients.
RESULTS: The NBS identified a sub-network difference at the mid-late period (300-500 ms) in response to happy faces among the three groups (corrected P = 0.035). Then, the post hoc and correlation analyses found five FCs were decreased in melancholic MDD patients and were related to HAM-D6 score, including FCs of left fusiform gyrus-right orbital inferior frontal gyrus (r = -0.52, P < 0.001), left fusiform gyrus-left amygdala (r = -0.26, P = 0.049), left posterior cingulate gyrus-right precuneus (r = -0.32, P = 0.025), left precuneus-right precuneus (r = -0.27, P = 0.049), and left precuneus-left inferior occipital gyrus (r = -0.32, P = 0.025).
CONCLUSIONS: In response to happy faces, melancholic MDD patients demonstrated a disrupted functional connective pattern (20-35 Hz, 300-500 ms), which involved brain regions in visual information processing and the limbic system. The aberrant functional connective pattern in reward processing might be a biomarker of melancholic MDD.